Most Recent Articles
Apr 1, 2021
ML201 - ESIS, Inc.: Grade A
Claims administrator properly processed reimbursement for ML201. Date of Service: 04/01/2021
Apr 1, 2021
ML200 - Mitsui Sumitomo Insurance: Grade A
Claims administrator properly processed reimbursement for ML200. Date of Service: 04/02/2021
Apr 1, 2021
ML204 - Contra Costa Schools Insurance Group: Grade A
Claims administrator properly processed reimbursement for ML204. Date of Service: 04/13/2021
Apr 1, 2021
ML204 - Sedgwick Claims Management Services: Grade F
Claims administrator failed to properly reimburse ML204. Sedgwick incorrectly denied valid medical-legal code as “not considered a valid reimbursable code.” Date of Service: ...
Apr 1, 2021
ML203 - AIG Claims, Inc.: Grade F
Claims administrator failed to properly reimburse ML203. AIG incorrectly denied valid medical-legal code as not in the fee schedule. Date of Service: 04/01/2021
Apr 1, 2021
ML200 - Next Level Administrators: Grade F
Claims administrator failed to properly reimburse ML200. Next Level Administrators incorrectly denied valid medical-legal code as not reimbursable. Date of Service: 04/08/202...
Apr 1, 2021
ML200 - Sedgwick Claims Management Services: Grade F
Claims administrator failed to properly reimburse ML200. Sedgwick incorrectly denied valid medical-legal code as “not considered a valid reimbursable code.” Date of Service: ...
Apr 1, 2021
ML200 - Liberty Mutual Insurance: Grade F
Claims administrator failed to properly reimburse ML200. Liberty Mutual incorrectly denied valid medical-legal code as exceeding fee schedule allowance. Date of Service: 04/0...
Apr 1, 2021
ML200 - Guard Insurance Group: Grade B
Claims administrator properly processed reimbursement for ML200. The lower grade reflects that the explanation of review (EOR) incorrectly lists 99199 as the ‘Rev./Proc. Code...
Apr 1, 2021
ML202 - Sedgwick Claims Management Services: Grade F
Claims administrator failed to properly reimburse ML202. Sedgwick incorrectly denied valid medical-legal code as “not considered a valid reimbursable code.” Date of Service: ...
Apr 1, 2021
ML201 - Sedgwick Claims Management Services: Grade F
Claims administrator failed to properly reimburse ML201. Sedgwick incorrectly denied valid medical-legal code as “not considered a valid reimbursable code.” Date of Service: ...
Apr 1, 2021
ML201 / MLPRR - Broadspire: Grade F
Claims administrator failed to properly reimburse ML201 and MLPRR. Broadspire incorrectly reduced reimbursement by taking a noncompliant PPO reduction. Date of Service: 04/13...